Esophagogastroduodenoscopy Ppt
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Transcript of Esophagogastroduodenoscopy Ppt
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ESOPHAGOGASTRODUODENOSCOPY
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ESOPHAGOGASTRODUODENOSCOPY
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ESOPHAGOGASTRODUODENOSCOPY
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ESOPHAGOGASTRODUODENOSCOPY
ESOPHAGUS
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ESOPHAGOGASTRODUODENOSCOPY
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ESOPHAGOGASTRODUODENOSCOPY
STOMACH
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ESOPHAGOGASTRODUODENOSCOPY
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ESOPHAGOGASTRODUODENOSCOPY
DUODENUM
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ESOPHAGOGASTRODUODENOSCOPY
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ESOPHAGOGASTRODUODENOSCOPY
VISUALIZE
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Esophagogastroduodenoscopy (EGD) is a type of endoscopic procedure that permits direct visualization of the upper GI tract using an endoscope (an illuminated optic instrument for the visualization of the interior of a body cavity or organ).
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Philip Bozzini – created the Litchleiter to examine the urinary tract, rectum and pharynx.
Antoine Jean Desormeaux – developed the instrument used to examine the urinary tract and bladder. (“Endoscope”)
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• Dr. Adolph Kussmaul - succeeded in taking a look inside the stomach of a living human body for the first time
• Dr. Rudolph Schindler invented a flexible gastroscope, that allowed examinations even while the tube is bent.
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This procedure is useful for examining clents who have:
1.esophageal, gastric, or duodenal abnormalities (ex. Gatroesophageal reflux disease)
2.acute or chronic GI bleeding3.pernicious anemia4. masses,
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5. Strictures 6. dysphagia 7. substernal pain 8. epigastric discomfort 9. inflammatory bowel disease.
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PROCEDURE
Endoscope
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Biopsy Forceps Cytology Brush
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Pre-procedure Care and Nursing Considerations
• Perform a complete history and perform a physical examination to determine whether EGD is appropriate.
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• Certain medications (such as aspirin and NSAIDS) should be discontinued at least seven days before an EGD to reduce the risk of bleeding.
• Clients undergoing endoscopic procedures require a signed consent.
• If the client is going home within 24 hours after the procedure, someone should be available to drive.
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• For clients with a history of cardiac valve disease or replacement, antibiotic prophylaxis may be required.
• To prevent aspiration of stomach contents into the lungs, keep the client NPO for 8 to 12 hours before the procedure. Assess the oral cavity, and report any loose teeth or lesions to the gastroenterologist.
• Remove the client’s dentures and any removable bridges.
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• Even with anesthesia, the client may experience some discomfort, nausea, or pressure. Tell the client to breathe through the nose during the procedure.
• Explain that the room will be cool and dark and that he or she will not be able to talk while the endoscope is in place.
• The patient should be in NPO for 6-8 hours prior to the procedure
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Intraprocedure Care
• During the procedure, monitor for cardiac and respiratory complications.
• Specific antagonists to benzodiazepines and opioids should be available for emergency reversal of drug effects.
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Postprocedure Care
• To prevent aspiration, place the client in the Sims position until the sedation and local anesthesia wear off. Withhold fluids and solids for 2 to 4 hours after the procedure or until the gag reflex returns. Test for return of the gag reflex by stroking the back of the client’s throat with a tongue blade to determine whether gagging occurs. Once the gag reflex returns, the physician may order anesthetic throat lozenges or normal saline gargles to ease throat irritation or hoarseness.
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• Monitor for bradycardia or other dysrhytmias that may occur as a result of sedatives or anesthetics.
• Assess for signs of esophageal or gastric perforation. Esophageal perforation may cause crepitus (crackling) in the neck (from air leakage), fever, bleeding, or pain.
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Complications:1.Bleeding
2.Infection
3.Perforation
4.Cardiopulmonary problems
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An abnormal EGD may be the result of:
Celiac disease - Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food.
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• Esophageal rings - a thin band of tissue that encircles the lining of the esophagus.
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• Esophageal varices (a sign of end-stage liver disease) - a complex of longitudinal tortuous veins at the lower end of the esophagus, enlarged and swollen
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• Esophagitis – inflammation of the mucosal lining of the esophagus
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• Gastroesophageal reflux disease - – backflow of contents of the stomach into the esophagus
Lower esophageal ring - abnormal ring of tissue that forms where the esophagus and stomach meet.
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• Inflammation of the stomach and duodenum
• Mallory-Weiss syndrome - tear in the esophagus
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• Strictures or narrowing of the esophagus
• Tumors or cancer in the esophagus, stomach, duodenum (first part of small intestine)
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• Ulcers - gastric (stomach) or duodenal (small intestine)
• Zenker diverticula (abnormal pouches in the lining of the intestines)
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PrecautionsUpper GI endoscopy should not be
performed in clients with:• Severe cardiovascular disease• Severe upper gastrointestinal
bleeding• History of bleeding disorders
such as platelet dysfunction or hemophilia
• Esophageal diverticula• Suspected perforation• Recent UGI surgery